NICE, FRANCE — Although many people are concerned about antibiotic resistance, far fewer understand how their actions contribute to the problem, according to a global patient survey.
Results from the COMPLy (Compliance, Modalities by Population, Lifestyle and Geography) survey show that noncompliance is a global phenomenon that varies widely among countries, and is associated with patient age, dosage regimen, and patient attitudes toward their physicians.
A combination of telephone and in-person interviews were conducted in the fall of 2005 with 4,514 participants from 11 countries who were 18 years or older and had taken a self-administered antibiotic in the past 12 months. Noncompliance was defined as missing a dose or day, or having any drug left over. A total of 4,088 patients were included in the study, which was sponsored by Pfizer Inc.
The preliminary results, presented at the 16th European Congress of Clinical Microbiology and Infectious Diseases, included:
▸ Overall, 22% of respondents admitted to being noncompliant with their last antibiotic treatment. Noncompliance rates ranged from 10% in the Netherlands to 44% in China.
▸ Of those surveyed, 8 in 10 reported that antibiotic-resistant germs are a very serious problem, but only 6 in 10 believed that taking an antibiotic improperly might reduce its effectiveness the next time it is used.
▸ Half of respondents believed leftover antibiotics could be saved and used again.
▸ Among those with leftover antibiotics, 74% said they saved them, 18% threw them away, 5% gave them to someone else, and 3% dealt with them by other means.
▸ Noncompliance among patients aged 18–29 years was twice as high (30%), compared with those 60 years and older (14%).
▸ Noncompliance was lower among patients taking one dose per day (15%), compared with those taking two doses per day (21%) or three or more doses daily (27%).
A patient's attitude toward his or her physician is another factor driving noncompliance, said Dr. Jean-Claude Pechère, who presented the results at the meeting. Patients who feel actively involved in decisions about the management of their condition are more likely to comply with an antibiotic regimen, compared with those who are critical of their physician's abilities or feel ignored.
Attitudes differ by country. For example, Americans tend to be more involved patients, whereas many Japanese patients feel ignored, said Dr. Pechère, COMPLy steering committee chair and professor emeritus, University of Geneva. Noncompliance was 19% in the United States, compared with 34% in Japan, according to the study.
He suggested that educational efforts be tailored to address intercountry variations and that physicians educate their patients about proper antibiotic use.
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